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Background: Epilepsy is a medical condition that requires long-term treatment with antiepileptic drugs. Different epidemiological studies revealed an increased risk of atherogenic cardiovascular diseases in patients under antiepileptic therapy. The possible etiologic suggestion is alterations of the serum homocysteine, folate, and vitamin B12 metabolism. Objective: To evaluate serum homocysteine, folate, and vitamin B12 level in patients under antiepileptic monotherapy. Methods: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College from July 2017 to June 2018 through purposive sampling. In this study, forty diagnosed patients under antiepileptic monotherapy and forty age and sex-matched apparently healthy control were selected according to selection criteria, from OPD of the Neurology department, Dhaka medical college hospital. Results: In patients under antiepileptic therapy, mean (±SD) of serum homocysteine (μmol/L), folate (ng/ml), and vitamin B12 (pg/ml) were 14.15±3.4, 13.61±2.02, 361.78±41.26 respectively. In the healthy control group, serum homocysteine (μmol/L), folate (ng/ml), and vitamin B12 (pg/ml) were 8.78±2.59, 16.71±2.06 and 366.69±44.15 respectively. Serum homocysteine level was found higher and folate level was found lower in patients with antiepileptic therapy which were statistically significant (p

Background : Postoperative wound infection is a common consequence following laparotomy for peritonitis. Peptic ulcer perforation followed by peritonitis remains as an important cause of mortality. In severe peritonitis, the use of exploratory laparotomy and intra-operative lavage with large amount of saline solution has been the standard of care to reduce risk of postoperative infections. Objective: To compare the outcome between povidone iodine mixed normal saline (N/S) lavage and conventional normal saline lavage in the management of peritonitis in a tertiary care public hospital in Bangladesh. Methodology: This was a randomized clinical trial conducted in the department of Surgery, Shaheed Ziaur Rahman Medical College Hospital, Bogura during July 2013 to December 2013. There were total 50 patients, selected by purposive sampling as a diagnosed case of peritonitis due to peptic ulcer perforation. All the patients were divided into 2 groups by using coin toss as group A (conventional N/S) and group B (povidone iodine mixed with N/S). The data were collected using the pretested data collection sheet. Results were tested by chi-square test to see their level of significance with a p-value at

The shrimp industry of Bangladesh is facing severe problems and results less production. A study was conducted under a DFID-funded research project (TROPECA) to investigate the issue during 2004. The study was done in an aquatic system of Dumuria Upazila of Khulna district comprising a river (semi diurnal tidal system), a canal and 10 shrimp ponds. Shrimp culture practices within the study area were mostly extensive to improved extensive system. Shrimp were being produced without proper pond preparation, water management, fry nursing, and feed management due to a lack of technical knowledge. There were also concerns about the risks associated with the consequence of higher levels of financial investment. Consequently, production rates were low, averaging only 191 kg ha-1 in the system. Entrance of untreated river water in the pond having less depth (

Anthropogenic activities in a watershed may pose human health risks due to faecal contamination of surface waters. Thus, socioeconomic development is important when predicting future microbial water quality. Moreover, climate change alters meteorological conditions, thereby affecting flow regimes as well as fate and transport of microorganisms. In this study, possible risks due to socioeconomic development and climate change were assessed for the drinking water source Lake Vomb in Sweden by means of water quality modelling. The hydrological model ArcSWAT and the hydrodynamic model MIKE 3 FM were used to simulate fate and transport of two microorganisms, i.e., Cryptosporidium and E. coli, from the watershed to the water intake. The hydrological model and the hydrodynamic model were calibrated and validated using observed data on water flow and water temperature, respectively. The water quality in the watershed and in the lake was simulated for a baseline scenario and for future scenarios in the second half of this century. The future scenarios were formulated based on Representative Concentration Pathways (RCPs) and Shared Socioeconomic Pathways (SSPs). The modelling results illustrated the effects of climate changes and of socioeconomic development. The results were also interpreted in the context of infection risks to drinking water consumers using quantitative microbial risk assessment. This study clearly illustrates that socioeconomic development is important to include when investigating future microbial water quality.

Surface water quality is among the significant challenges in the Sutlej River basin, passing through Pakistan's most densely populated province. Currently, the overall surface water quality is grossly polluted, mainly due to the direct discharge of wastewater from the urban areas to the Sutlej River directly or through stream networks. Escherichia coli concentrations vary under extreme weather events like floods and droughts and socioeconomic circumstances like urbanization, population growth, and treatment options. This paper assesses the future E. coli load and concentrations using the Soil and Water Assessment Tool (SWAT) along with scenarios based on Shared Socioeconomic Pathways (SSPs) and Representative Concentration Pathways (RCPs) developed by the Intergovernmental Panel on Climate Change (IPCC). E. coli concentrations according to a more polluted scenario disclose a near and mid future increase by 108% and 173%, and far future increases up to 251% compared to the reference period (baseline) concentrations. The E. coli concentration is reduced by - 54%, - 68%, and - 81% for all the projected time steps compared to the baseline concentrations. While highly improved sewerage and manure management options are adapted, the concentration is further reduced by - 96%, - 101%, and - 105%, respectively, compared to the baseline. Our modeling and scenario matrix study shows that reducing microbiological concentrations in the surface water is possible. Still, it requires rigorous sanitation and treatment options, and socioeconomic variables play an essential role besides climate change to determine the microbiological concentration of water resources and be included in future studies whenever water quality and health risks are considered.

Background: Coronavirus Disease (COVID-19) vaccines have been licensed for usage and have been delivered over the globe in various regions. There is a lack of public awareness and understanding of COVID-19 vaccinations, however. As a result, researchers conducted a survey to see what Bangladeshis had to say about COVID-19 vaccinations. Methods: This cross-sectional study, conducted among the general population of Bangladesh, asked a series of questions about the KAP of the population with regard to COVID-19 vaccination, and the demographic characteristics of participants and the source of information with regard to the COVID-19 vaccine were recorded and analyzed. Results: A total of 386 complete surveys were included in the final analysis. 35.2% of people, who took part in it, said that everyone in Bangladesh should get the COVID-19 vaccine, while 64.8% said no to this idea. As a result of our survey, 73.6% of respondents believed that the new COVID-19 vaccination, which is now used in Bangladesh, may cause negative effects. Although a large number of the population was illiterate (44.6%), our study indicated that those with higher levels of education had a better understanding of the COVID-19 vaccination. This research indicated that those who had previously received a vaccination had a better understanding of the COVID-19 vaccine. For this to be successful, people must have had positive vaccination experiences in the past. There is a far greater awareness about COVID-19 vaccinations in urban areas compared to rural places. However, when multiple regressions were used, this association did not hold up. Conclusion: In Bangladesh, many are unfamiliar with the COVID-19 vaccination, but they have a positive attitude toward it. Before mass vaccines are planned in the near future, health education campaigns must begin immediately to assist people in better understanding their health.

Background: In a public health crisis, knowledge and understanding of disease transmission modes, fundamental hygiene concepts, and procedures are critical for designing effective control measures. The purpose of this research was to assess the Bangladeshi population's Knowledge, Attitude and Practice (KAP) towards COVID-19. Methods: A series of questions about the KAP of the population about COVID-19 were asked in this cross-sectional study, which was conducted among the general population of Bangladesh over the age of 15, and participants' demographic characteristics and source of information about COVID-19 were recorded and analyzed. Results: Despite the fact that the majority of respondents (more than 60%) had a positive attitude about COVID-19, 70% of those questioned in Bangladesh had insufficient understanding and preventative actions. This latter discovery is promising and suggests a potential therapeutic strategy. Male and less educated respondents reported inadequate COVID-19 preventive methods, as well as a lack of understanding about signs and symptoms and transmission. The findings revealed a substantial link between knowledge, attitude, and practice among women of a certain gender, age, and education level. Male gender, non-healthcare-related jobs, single status, and a lesser degree of schooling were all substantially correlated with poorer knowledge scores, according to multiple linear regression analysis. Conclusion: The present study revealed a high attitude among the study population towards COVID-19 but a poor response on knowledge and preventive practices, which can be enhanced by awareness campaigns and proper planning.

Aim: Tuberculosis (TB) and diabetes mellitus continue to be significant public health problems. Diabetes screening of tuberculosis patients will provide early case diagnosis, improved diabetes control, and improved tuberculosis treatment result. The purpose of this study was to ascertain the prevalence and risk factors for diabetes in tuberculosis patients, as well as their influence on the treatment result of tuberculosis. Methods: This cross-sectional study was conducted at Bangladesh's randomly chosen peripheral health institutions. All TB patients above the age of 18 years were checked for diabetes. Age, gender, family history, smoking, and BMI were all considered as risk factors. Results: Out of 165 participants, diabetes was shown to be prevalent in 35% of TB patients. Diabetes was related to advanced age and type of tuberculosis; its origin (pulmonary or extra pulmonary) and socioeconomic level were found to be significant. Conclusion: Diabetes is a common comorbidity among tuberculosis patients. Over the age of 50 years, the risk of this twin morbidity increases significantly. Screening tuberculosis patients for fasting blood sugar values will aid in the early diagnosis of diabetes and will lead to a better prognosis.

The microtubule-associated protein tau is involved in more than 20 different neurological disorders characterized by aberrant intracellular aggregation of tau in the brain. Here, we investigated the aggregation of a novel 20-residue model peptide, tau

Abnormal deposition of tau in neurons is a hallmark of Alzheimer's disease and several other neurodegenerative disorders. In the past decades, extensive efforts have been made to explore the mechanistic pathways underlying the development of tauopathies. Recently, the discovery of tau droplet formation by liquid-liquid phase separation (LLPS) has received a great deal of attention. It has been reported that tau condensates have a biological role in promoting and stabilizing microtubule (MT) assembly. Furthermore, it has been hypothesized that the transition of phase-separated tau droplets to a gel-like state and then to fibrils is associated with the pathology of neurodegenerative diseases. In this review, we outline LLPS, the structural disorder that facilitates tau droplet formation, the effects of posttranslational modification of tau on condensate formation, the physiological function of tau droplets, the pathways from droplet to toxic fibrils, and the therapeutic strategies for tauopathies that might evolve from toxic droplets. We expect a deeper understanding of tau LLPS will provide additional insights into tau physiology and tauopathies.

Background: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females, accounting for 23 percent of total cancer cases and 14 percent of cancer deaths.1 The lifetime probability of developing breast cancer is one in six overall (one in eight for invasive disease).2 In Bangladesh breast cancer is the 2nd most common cancer and also 2nd most leading cause of cancer death among the female population after cervical cancer.3 Despite the decreases in incidence rates in North America, breast cancer incidence has been increasing in other parts of the world, such as Asia and Africa. These international differences are thought to be related to societal changes occurring during industrialization.4,5 Methods: This was a Prospective Observational cross-sectional studyconducted among the 150 adult patients of breast carcinoma admitted in Department of surgery of Dhaka Medical College & Hospital, Bangabandhu Sheikh Mujib Medical University and Ahsania Mission Cancer & General Hospital during July 2012 to June 2013. After admission in surgery department, diagnosed patients (by ultrasonography and FNAC) with breast cancer were evaluated by history and physical examination, ultrasonography or mammography in a data collection sheet by the study physician.Tumor size was measured by physical examination, ultrasonography or mammography and during histopathological slide preparation. Histopathology of the dissected axillary lymph nodes determined the axillary lymph node status.Case record forms with appropriate questionnaire were filled for all patients. Results: This prospective documented study enrolled 150 cases of diagnosed breast cancer patient. The mean (+SD) age of the patients was 42.16 + 11.18 years with the range from 18 – 65 years. In this study, commonest presentation was painless breast lump in case of 84% patients. Next to it was nipple retraction (40%). Clinically, 52% of study populations were at stage II. Histologically, most of the tumor was at T2 stage (2.1 to 5 cm). Duct cell carcinoma was the predominant histological type (99.33%) and 58% patient had grade II tumors. 66% population showed metastasis of tumor cells in the axillary lymph node(s). Frequency of axillary lymph node metastasis increased as the tumor size increased. We found 33.33% T1 tumors had axillary lymph node metastasis, where as 58.97% T2 tumors and 93.75% T3 tumors showed axillary lymph node metastasis respectively. AKMMC J 2020; 11(2) : 107-112

Non-communicable disease (NCD) is now a burning public health issue in Bangladesh. Among crucial NCD risk factors, widespread low high-density lipoprotein cholesterol (HDL-C) levels is of top concern in Bangladesh. Over the last ten years, through an extensive nationwide investigation in Bangladesh, we found that more than 80% apparently healthy rural women in Bangladesh have low HDL-C levels. Thus, the present study investigated whether a lifestyle intervention program through daily walking could improve the low HDL-C levels in these women. A total of 231 rural women in Bangladesh were studied using an interventional approach, and analysis was performed based on a case-control design between low HDL-C and normal HDL-C. The subjects underwent a ten-week daily walking program (1.5 km walk twice a day). Among 231 participants at baseline, those with low HDL-C levels were 82.5%. Mean total HDL-C levels were 39.4 mg/dl in low HDL-C subjects and 56.1 mg/dl in normal HDL-C subjects, respectively, at baseline levels. The percentage of hypertriglyceridemia was 25.5% in low, and 10.3% in normal HDL-C subjects and the percentage of diabetes mellitus was 16.4% in low and 7.7% in normal HDL-C subjects before the exercise intervention. Although blood glucose levels and blood pressure were not changed significantly after the exercise intervention, low HDL-C levels were significantly improved with exercise (baseline, 39.8 ± 0.56; exercised, 46.3 ± 1.01, p < 0.001). The current research findings show that even a 10-week mild exercise program improved low HDL-C levels in rural Bangladeshi women, which can be a potential strategy for the prevention of NCD.

In December 2019, a new human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was discovered in Wuhan, China. Since then, the virus has spread over the world, affecting over 180 nations. SARS-CoV-2 has infected people of all ages, races, and genders, infecting both men and women and spreading at an alarming pace across communities. Given the virus's origin, much remains unknown; however, we do know that clinical presentations vary from a typical cold to more serious infections, including pneumonia, bronchitis, severe acute respiratory distress syndrome (ARDS), multi-organ failure, and even death. COVID-19 is thought to have a more fast and severe progression in people with underlying health issues or co-morbidities, frequently resulting in death. Methods: This retrospective study was conducted at Bangladesh's Tertiary care hospital. 534 patients were selected for this study. Medical history, age, gender, and co-morbidities (including Hypertension, Diabetes, and CKD, etc.) were recorded at the time of diagnosis, biochemical parameters such as CRP, ESR, creatinine, FBS, Hb, and LDH were also recorded. SARS-CoV-2 RNA was detected using a real-time reverse transcription-polymerase chain reaction (rRT-PCR) at diagnosis and throughout the follow-up of these patients. Results: The comorbid conditions, illness progression, and death rates in patients from a Bangladeshi tertiary care hospital were investigated in this study. COVID-19 patients with co-morbidities, such as hypertension or diabetes, are more likely to have a more severe course and development of the disease. Furthermore, individuals over the age of 60 who have co-morbidities and are infected have a higher incidence of admission to the intensive care unit (ICU) and death from the COVID-19. Conclusion: Where Vaccination, Early diagnosis, and Management lead to a better prognosis, patients with co-morbidities should take all steps to prevent contracting SARS CoV-2 since their prognosis is generally the poorest.

Aim: Metabolic Syndrome (MetS), a significant risk factor for coronary artery disease (CAD), is now highly prevalent in South Asian countries, including Bangladesh. The diseases also affect young people. A large number of young populations with acute coronary syndrome (ACS) have MetS. The aim of this study was to determine the prevalence of MetS and the combination of components in patients with early age onset ACS (age ≤50 years). Methods: This prospective study comprised 678 consecutive patients age ≤50 years hospitalized for ACS during 2012-2013. The patients were categorized according to the criteria stated in the latest joint statement for the global definition of MetS. Results: Among 678 ACS patients, 236 (34.8%) patients have filled the criteria of MetS. The mean age was 42.4 ± 0.28 years. The prevalence of MetS was higher in females than in males (48.8% vs. 30.4%, p < 0.001). One component of MetS was found in 26.4%, two components in 29.8%, three or more components in 34.8% of young ACS study participants. Among the various components of MetS, low HDL and high TG were the crucial common components of MetS in young ACS patients in Bangladesh (low HDL: 51.9%, high TG: 44.8%). Conclusions: We conclude that the prevalence of MetSin patients with early age onset ACS (age ≤50 years) is high in Bangladesh. Since Low HDL and high TG are the most common components of MetSin our study, these biochemical parameters would be a clinical target for early treatment. Strategies are needed for the early detection and treatment of cardio-metabolic risk factors to prevent coronary artery disease progression and prognosis.

Tauopathies are neurodegenerative diseases characterized by the deposition of abnormal tau in the brain. To date, there are no disease-modifying therapies approved by the U.S. Food and Drug Administration (US FDA) for the treatment of tauopathies. In the past decades, extensive efforts have been provided to develop disease-modifying therapies to treat tauopathies. Specifically, exploring existing drugs with the intent of repurposing for the treatment of tauopathies affords a reasonable alternative to discover potent drugs for treating these formidable diseases. Drug repurposing will not only reduce formulation and development stage effort and cost but will also take a key advantage of the established toxicological studies, which is one of the main causes of clinical trial failure of new molecules. In this review, we provide an overview of the current treatment strategies for tauopathies and the recent progress in drug repurposing as an alternative approach to treat tauopathies.